Local health officials have mixed feelings on the historic court decision Thursday that upheld the health care law, with some saying it’s a step forward for public health while others contend it’s a step back for small businesses.
The 5-4 U.S. Supreme Court ruling was hotly discussed at the Franklin County Health Department’s Employees and Partners Picnic Thursday shortly after the decision was announced.
“Personally, I’m ecstatic, because of the access issue,” said the department’s director, Paula Alexander, as she flipped burgers outside the health department off the East-West Connector.
“I know there’s going to be questions: ‘How do we do it?’ and ‘Where do we get the providers?’ but it’s going to open up several hundred thousand, in Kentucky alone, to health care.”
A majority of the Supreme Court justices ruled that the Affordable Care Act, unofficially known as “Obamacare,” was constitutional, saying Congress has the authority to require nearly everyone to purchase health care or pay a fine.
The decision extends coverage to the 30 million Americans and about 600,000 Kentuckians who are now uninsured. More than 900,000 Kentuckians who were previously denied coverage for pre-existing conditions will now get coverage.
Since the decision was just announced, several officials at the picnic declined to comment, saying they’d like time to research the lengthy bill and nearly 200-page-long court decision.
City Manager Fred Goins, former health department director, said he’s interested in learning more to see if the law can address health insurance concerns in Frankfort.
“I’d like to see what the implications are for our health insurance plans,” Goins said. “Our health insurance has been going up $400,000-$500,000 a year, so we would sure like some relief, and we hope that there’s something in this bill that will give the city some relief.”
But some at the picnic said the federal government is overstepping its boundaries.
“(The law)’s good for the health department … but personally, it just kind of galled me, that they demand you purchase something that you may not want,” said Scott Green, who served on the county Board of Health for 18 years.
Opponents also say studies suggest the health care law will hurt small business owners and predict private employers will be forced to reduce or eliminate coverage. A provision in the new law requires companies with more than 50 employees to provide health insurance for its full-time workers.
“That money, where is it going to come from?” asked Wayne Morris, owner of Wayne’s Pharmacy. “I think this will curtail employment for a lot of companies.”
But Morris said he didn’t completely disagree with the law, adding that he supports the provision that prohibits health plans from denying coverage to those with pre-existing conditions.
Several at the picnic also praised the law for its extended Medicaid coverage. Starting in 2014, it will allow those with an income 133 percent above the federal poverty level to qualify for Medicaid, a move that will extend health care coverage to an estimated 261,000 Kentuckians.
“We have families … who can’t afford insurance but are denied Medicaid … people who fall in between the cracks,” said Rhonda Kays, a registered nurse in the county health department’s Health Access Nurturing Development Services program.
Julie Reynolds, also a nurse in the HANDS program, added, “So sometimes it gets them in a position, does it do them any good to work? Because it puts them in a different category where they don’t get food stamps and don’t qualify for other programs like Medicaid.
“So sometimes it pays them better not to work … and we don’t want to encourage that.”
Several programs in Medicaid will also be expanded.
According to Kentucky Voices for Health, a grass roots organization working to improve the state’s health care services, the health care law provides an option that will pay for personal attendant services and extends Home and Community Based Waiver services (programs that provide home health care in lieu of nursing homes) from 150 percent to families 300 percent above the federal poverty level.
“So all these patients that we deal with who are just on the edge of that cutoff point because they make just a little bit over, they’re now going to be able to get that service, which is great and really helps people,” said social worker Shannon Rome, who helps run the HCB Waiver program at the county health department.
“Everyone wants to stay at home and not be in a nursing home, and so if we can serve more people because it’ll increase that income level, it’ll be awesome.”
The health care law also allows young adults to stay on their parents’ health insurance until 26, which will provide coverage to more than 16,000 Kentuckians.
The health care overhaul focus will now shift from Washington, D.C., to state capitals. Only 14 states, plus D.C., have adopted plans to set up the new health insurance markets called for under the law.
The new markets are supposed to be up and running on Jan. 1, 2014. People buying coverage individually, as well as small businesses, will be able to shop for private coverage from a range of competing insurers.
Gov. Steve Beshear announced Thursday his plans to issue an executive order “soon” to establish an online exchange that’s intended to help the more than 600,000 uninsured Kentuckians find affordable health coverage.
“This Supreme Court decision removes much of the uncertainty about the Affordable Care Act,” the governor said in a statement. “Kentucky has been systematically preparing to meet the implementation deadlines set forth in the bill as a precautionary matter.”
Republicans are already gearing up for a fight to repeal the act.
“Americans want it repealed, and that’s precisely what we intend to do,” U.S. Senate Republican Leader Mitch McConnell declared Thursday.
“Americans want us to start over. And today’s decision does nothing to change that. The court’s ruling doesn’t mark the end of a debate. It marks a fresh start on the road to repeal. That’s been our goal from the start. That’s our goal now. And we plan to achieve it.”
Those at Thursday’s picnic said they realize there’s more work ahead, and changes may be forth coming before most of the plan goes into effect within the next two years. But several nonetheless applauded the government’s effort.
“In general, just the idea to do something about the enormous problems in our health care system, something has to be done,” Rome said.
“So at least they’re taking steps and trying to make measures to help people get coverage. That’s important.”
The Associated Press contributed to this report.